Purse string antimesenteric border, do not tie off
Enterotomy
Feed tube into jejunum and blow up balloon
second outer purse string in jejunum and peritoneum
Showing posts with label Small bowel. Show all posts
Showing posts with label Small bowel. Show all posts
Friday, September 14, 2007
Small bowel resection
Mayo scissors to open rectus
Non crushing clamp at each end
single Artery forcep: on jaw through mesentery. Overap in a line then apply crushing clamp to specimen
Cut behind crushing clamp and arteries with scalpel to excise specimen then vicryl ties to arteries
3-0 PDS suture mesenteric border of specimen, leaving artery on short end.
Continuous suture one side to antimesenteric border, then pass artery through mesenteric window to expose other side then tie of suture
Reinforce with interrupted 3-0 PDS
Test for watertightness
2 Artery forceps on cut edges of mesentery (Hoffman style) then tie with 2-0 vicryl
Non crushing clamp at each end
single Artery forcep: on jaw through mesentery. Overap in a line then apply crushing clamp to specimen
Cut behind crushing clamp and arteries with scalpel to excise specimen then vicryl ties to arteries
3-0 PDS suture mesenteric border of specimen, leaving artery on short end.
Continuous suture one side to antimesenteric border, then pass artery through mesenteric window to expose other side then tie of suture
Reinforce with interrupted 3-0 PDS
Test for watertightness
2 Artery forceps on cut edges of mesentery (Hoffman style) then tie with 2-0 vicryl
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